AIDS neurological damage, the main physiological changes are immune function defects, prevention is important

Introduction: The disease, also known as acquired immunodeficiency syndrome, is a human immunodeficiency virus caused by HIV (Human Immunodeficiency Virus). Normally, patients who have been infected with HIV are called AIDS patients, and people who are not infected with HIV are the source of the infection that causes AIDS nerve damage.

01 What is the main etiology and pathology of AIDS neurological damage? What is the pathogenesis of this disease?

1、Pathogenesis

HIV is a subfamily of retroviral diseases, including HIV-1 and HIV-2. its virulence and pathogenicity are higher than that of HIV-2. it is the main pathogenic microorganism. HIV-2 infection is currently limited mainly to AIDS patients in certain countries in West Africa. the pathogenesis of AIDS is unknown. the HIV-1 virus itself and its metabolites are directly pathogenic. It is active by reverse transcription of chromosomal group RNA into double-stranded DNA, which is then transferred to the host cell nucleus and integrated by integrase into the host chromosome, forming a long-term structure. The organism is unable to remove it, remain quiescent, or actively participate in the production of the virus with high gene expression. HIV-1 also has pro-neural properties, and this property can be mutated to obtain a specific variant of the parent nerve.

2. Pathogenesis

The pathophysiological alteration characteristic of AIDS is a severe immune deficiency. HIV-1 binds to CD4-positive cells via the glycoprotein gp120 membrane expression. gp120's receptor is CD4. human CD4-positive cells are mainly helper T cells (th). After HIV-1 enters the cells, as the virus continues to replicate, apoptotic mechanisms are disrupted, leading to a reversal of the th/ts ratio in vivo, thus making the organism more susceptible to multiple opportunistic infections and certain tumors that can kill the patient.

02 What are the main signs and symptoms of having AIDS neurological damage? How is the diagnosis usually made?

1、Signs of the patient

HIV is a pro-neuro virus and can invade the nervous system at the early stage of the disease. Therefore, the central nervous system of AIDS is mainly caused by the direct invasion of HIV; secondly, the immune mechanism of the human body is suppressed or there is an immune deficiency, which leads to easy infection of the virus, bacteria, fungus, etc., or secondary tumor after HIV infection. The combination of the two can make a person more susceptible to disease.

(1) Primary neurological disease of AIDS

HIV-induced CNS can become inflamed, demyelinated, or degenerated, some of which are thought to be AIDS-defining lesions.

(2) Acute granulomatous cerebral vasculitis

Granulomatous inflammation is widely distributed in the anterior, middle, and posterior arteries and their proximal branches, involving the basal ganglia, inner envelope, subcortical white matter, parieto-occipital cortex, and pontine cap, and is a major site of cerebral infarction. Its clinical manifestations are high fever, psychiatric symptoms, and paroxysmal disorders of consciousness with local symptoms.

(3) Vacuolar myelopathy

It can occur alone or in combination with AIDS dementia syndrome. It manifests as vacuoles in the white matter of the spinal cord, mainly involving the lateral and posterior aspects of the spinal cord. The main manifestation is the thoracic medulla, which resembles subacute degenerative joint changes. For some progressive spastic paraplegia, ataxia, incontinence, and vesicle-like changes in the brain, the clinical presentation is progressive dementia.

2、Diagnosis method

(1) Asking for medical history, etc.

When diagnosing encephalitis, spinal cord, neurological and muscular diseases, a detailed medical history should be taken to consider the possibility of AIDS and careful differentiation.

(2) Various clinical manifestations

The clinical manifestations of neurological diseases caused by AIDS are complex and varied. Under certain conditions, AIDS patients may have a combination of toxoplasmosis, herpes simplex disease, tuberculosis, syphilis, and other infections, and may have more than two types of impairment at the same time. For example, AIDS dementia is often associated with spinal cord disease, and several AIDS conditions can have similar symptoms, such as intracranial occupying lesions, toxoplasmosis, tuberculous granuloma, fungal granuloma, bacterial brain abscess, primary lymphosarcoma, etc., all of which should be considered together.

03 has AIDS neurological damage, the main examination methods are HIV antibody test, PCR technology, etc.

1、HIV antibody test

The p24 antibody is initially expressed after HIV infection and gradually disappears after a few weeks, but the p24 and gp41 antibodies gradually appear. Once antibodies are found, it is assumed that the virus is present.

2、Antigen detection

ELISA double antibody sandwich method is used to detect p24 antigen in serum and cerebrospinal fluid. The former method helps in the diagnosis of antigenemia in patients with acute infection, and the latter method helps in the diagnosis of dementia syndrome.

3、PCR technique

The radiation autoradiography technique can detect small amounts of viral DNA and can determine the location of the virus.

4、Cerebrospinal fluid examination

Smear staining, virus isolation and culture, and measurement of antigen and antibody titers are used to determine the type of infection and virion.

5、Brain tissue biopsy

For patients with suspected AIDS lesions in the brain, it is diagnostic to determine the biopsy site through CT and MRI examination.

04What are the main complications of having AIDS neurological damage? How to carry out the treatment?

1、 Complication

Because HIV is the causative factor of AIDS, once infected by the body, it will destroy the immune system. Therefore, AIDS can cause opportunistic infections and tumor complications of various causes during the disease, and the complications can come along with it. For example, Kaposi's sarcoma may be complicated by central nervous system infection. AIDS patients are particularly prone to other diseases in the late stage due to their immune deficiency, and also develop multi-organ failure (MOSF) secondary to metabolic encephalopathy.

2、Treatment method

The main problem of AIDS is to prevent infection, once infected, the consequences can be serious, so attention should be paid to cutting off the three main transmission routes, such as sexual contact transmission, blood transmission, and mother-to-child transmission, to reduce the incidence.

(1) Drug treatment

No drugs have been identified specifically for the treatment of HIV infection. The different mechanisms of HIV infection, replication, T helper cell binding, and death are highlighted. HIV is a chronic infection process and the virus mutates more significantly, so monotherapy is prone to resistance and requires high doses.

(2) Surgical treatment

Brain surgery is not the primary treatment for central nervous system injury in AIDS. Extracranial surgery is feasible for single lymphomas without extracranial metastases, Kaposi's sarcoma, and granulomas or abscesses due to HIV-associated pathogenic infections. Ventricular-abdominal shunts may also be considered for hydrocephalus due to infection. Biopsy techniques play an important role in the diagnosis of this disease.

(3) Radiation therapy

AIDS-related intracranial tumors are radiation-sensitive, and radiotherapy is an important and effective treatment. prognosis of central nervous system injury in AIDS is poor. With comprehensive treatment, most AIDS patients survive less than 2 months after diagnosis. People with AIDS who have Toxoplasma gondii can survive for up to a year.

Conclusion: The main problem of AIDS is the prevention of infection. Once infected, the consequences can be serious, so attention should be paid to cutting off the three main transmission routes, such as sexual contact transmission, blood transmission, and mother-to-child transmission, to reduce the incidence of the disease. The focus of this disease is on prevention, and if you get sick, you need to treat it in time.